TY - JOUR
T1 - Neutropenic enterocolitis
T2 - Is there a right timing for surgery? Assessment of a clinical case
AU - Bagnoli, Pietro
AU - Castagna, Luca
AU - Cozzaglio, Luca
AU - Rossetti, Carlo
AU - Quagliuolo, Vittorio
AU - Zago, Mauro
AU - Santoro, Armando
AU - Doci, Roberto
PY - 2007/11
Y1 - 2007/11
N2 - Neutropenic enterocolitis is a severe and potentially life-threatening complication that may affect patients undergoing chemotherapy for acute leukemia or lymphoma. These patients may develop systemic sepsis through bacterial or fungal translocation across the intestinal wall. In many cases neutropenic enterocolitis is confined to the cecum, but the entire colon is sometimes involved. Most patients are treated conservatively because an improvement occurs when the absolute neutrophil count rises. However, a surgical approach consisting of resection of the colon may sometimes be necessary, even in patients with complete aplasia and a high risk of complications. The right time to perform surgery is hard to define. Intestinal wall thickness, evaluated by ultrasound, is an important prognostic factor which could act as a guide to surgical indication. We analyze a case of neutropenic enterocolitis which occurred in a patient with acute myeloid leukemia during chemotherapy and we suggest that, as well as intestinal wall thickness, hemodynamic worsening should be considered an indication for surgery.
AB - Neutropenic enterocolitis is a severe and potentially life-threatening complication that may affect patients undergoing chemotherapy for acute leukemia or lymphoma. These patients may develop systemic sepsis through bacterial or fungal translocation across the intestinal wall. In many cases neutropenic enterocolitis is confined to the cecum, but the entire colon is sometimes involved. Most patients are treated conservatively because an improvement occurs when the absolute neutrophil count rises. However, a surgical approach consisting of resection of the colon may sometimes be necessary, even in patients with complete aplasia and a high risk of complications. The right time to perform surgery is hard to define. Intestinal wall thickness, evaluated by ultrasound, is an important prognostic factor which could act as a guide to surgical indication. We analyze a case of neutropenic enterocolitis which occurred in a patient with acute myeloid leukemia during chemotherapy and we suggest that, as well as intestinal wall thickness, hemodynamic worsening should be considered an indication for surgery.
KW - Acute myeloid leukemia
KW - Neutropenic enterocolitis
KW - Total colectomy
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=38549138307&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38549138307&partnerID=8YFLogxK
M3 - Article
C2 - 18338498
AN - SCOPUS:38549138307
VL - 93
SP - 608
EP - 610
JO - Tumori
JF - Tumori
SN - 0300-8916
IS - 6
ER -